Individual
MR. HERMAN SHANE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
82 MAIN ST W, MEADVILLE, MS 39653-9320
(601) 384-3105
Mailing address
PO BOX 919, MEADVILLE, MS 39653-0910
(601) 384-3105
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-7455
MS
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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